billylee wrote:Any comment to the two different approaches?
How is the Titan?
Thanks
billy
Well, what I wanna explain at first in general is that the Mentor/Coloplast devices are more suitable for rather big penises compared to the AMS ones. Girth with a Titan is superior to girth with an AMS. Titan has no length extension, so when you have a short penis and put a Titan in it, it will keep on being short in erected state and that's not quite ideal.
Furthermore, the bioflex material of the cylinders is not that soft even in the flaccid state. That means, you have a steeper angle with your flaccid penis and a certain consistence on being flaccid which in my personal case resembled more to my natural situation (used to have a penis staying away from the body at some 40 degrees and not hanging down vertically.) That's my very personal evaluation, so I'd recommend to someone with a rather steep penis by nature (when flaccid) a Titan device because the everyday body feeling with the flaccid penis in its pants might appear more familiar.
I felt a bit uncomfortable in everyday life with my AMS 700CX (being operated by the infrapubic approach) when dick was flaccid, in addition the pump has been placed on the very margin of the scrotum which they don't do anymore nowadays. Functionally it was immaculous; but the durability was ridiculous! This topic too is no big deal anymore right now due to well known material improvements by AMS.
Regarding the operational approach, I have to confess that the infrapubic approach always worked well with me. No loss of sensitivity. The AMS cylinders were 21 cm long, the penis was long enough but very lean. After the explantation and 5 months without an implant, the surgeon had some trouble on dilating and inserted Mentor Alpha I with 19cm cylinders which were obviously too short for my body, but surprisingly functioned perfectly thru all the time. It has been inserted by penoscrotal approach.
Right now I've got problems with cylinder size with my new Titan, coz the right cylinder is fitting perfectly, but the left one resulted too short due to remarkable differences of the corpora sizes (23 cm vs. 25 cm). Not only the corpora size were measured different, particularly the proximal part of my left cavernous body is 1cm deeper than its neighbour. And that's the crucial point: In order to have the distal ends of the implant's cylinders reach out at equal level distally onto the glans, you need to adapt them proximally by different length of RTEs. Dr. Eid confirmed me this logical necessity, but obviously it's a very rare case and all the surgeons I know here in Germany never implanted two different sized cylinders.
So at the end of the day I need a correction of my last OP, a revision of the revision, and I'm a bit upset due to that fact, because IMHO if they would have thought creatively and improvised in the OP, they would have recognized that the special measurement result entails the necessity of putting a longer cylinder (1cm more RTE) into the left part than into the right one - thus leaving their track of dragged-in routine.
and underwent 5 operations, among them 4 implantation and one sole explantation. I know Small-Carrion, AMS 700 CX, Mentor Alpha I and as of now Titan OTR zero degree.